Imiquimod works by treating warts on the external genitals as well as the perianal area in adults. The common dosage form of imiquimod is cream, which is an immunomodulatory drug. It is used clinically to treat acromegaly in the external genital area and also in the perianal area in adults. Imiquimod produces immunomodulatory and indirect antiviral effects locally. Imiquimod induces the production of a variety of cytokines in vitro, including alpha-interferon, alpha-tumor necrosis factor, IL-1α, IL-1β, IL-6, C-CSF, and GM-CSF. Adverse effects of imiquimod use include visible wart site burning, hyperpigmentation, inflammation, itching and other discomfort. It is contraindicated in case of hypersensitivity to imiquimod or excipients. Sexual contact should be avoided while using the drug. Imiquimod should be used under the supervision of a doctor.